Objective To analyze the MRI findings of spinal intramedullary tuberculomas and the related literature was reviewed. Methods A retrospective study of 5 patients with intramedullary tuberculoma proved by clinical and radiological evidences was undertaken.Both T1-and T2-weighted images were obtained along with the postcontrast T1 WI.The locations,signal intensities,patterns of enhancement and morphology of the tuberculomas were observed.Results A tuberculoma in one patient was found in cervical spinal cord with slight hypointensity and nodular enhancement on T1 WI and hypointensity on T2 WI.Those in three patients were found in inferior thoracic spinal cord with typical “target sign”on T2 WI and rim-enhancement on postcontrast T1 WI,and the tuberculomas were ovoid along the long axis of spinal cord on sagittal images.A miliary tuberculoma in thoracic spinal cord in one of these three patients was found which could not be showed on plain MRI.The tuberculomas in last patient was located in conus terminalis with hypointensity and rim enhancement on T1 WI and hypointensity on T2 WI.Conclusion The MRI findings of spinal intramedullary tuberculoma are variable,and their characteristic manifestations include hypointensity or “target sign”on T2 WI,rim enhancement on postcontrast T1 WI along the long axis of spinal cord.

Objective To investigate the association of serum brain-derived neurotrophic factor (BDNF) and methylglyoxal (MG) levels with cognitive function in elderly patients with type 2 diabetes mellitus (T2DM). Methods The normal population and elderly patients with T2DM were frequency-matched by age, sex, and educational level. BDNF was detected by ELISA assay, MG by HPLC assay, and cognitive function by sets of repetitive mental state examination (RBANS) in the two groups. Results (1) Compared with control group, serum BDNF level in T2DM group was significantly decreased [ (4.97±3.05 vs 11.77±7.92)ng /ml, P<0.01]while serum MG level was elevated [(67.91 vs 43.86) nmol /L, P<0.05]. The increasing of serum MG was related to the decreasing of serum BDNF. (2) Compared with control group, the scores for standardized tests of cognitive scale, visual breadth, immediate memory, delayed memory, and attention areas in T2DM group were significantly decreased (all P<0.05). After the influencing factors were adjusted by multiple regression, the associations of serum BDNF level with cognitive scale standardized score, the delay associated with memory and attention functions were still evident, and serum MG level in T2DM group was still related with the levels of delayed memory, immediate memory, total scale standardization (all P<0.05). (3) Serum BDNF level was negatively correlated with serum MG level (P=0.031). Conclusions Cognitive function of elderly patients with T2DM is related with serum MG and BDNF levels. The increased serum MG as well as the decreasd serum BDNF levels maybe involved in the pathogenesis of impaired cognitive function.

Objective To investigate the clinical efficacy of intraoperative methylprednisolone used in combination with perioperative enteral nutrition support in improving liver synthetic function after hepatectomy and postoperative recovery.Methods In this prospective controlled trial,79 patients treated with hepatectomy at Departement of Hepatobiliary Pancreatic Surgery in Drum Tower Hospital between June 2013 and May 2014 were included and divided into control group (n =39) and steroid group (n =40) according to the order of surgery.The control group underwent hepatectomy only,while the steroid group received intraoperative methylprednisolone (500 mg) at the start of liver excision.Both of the two groups were given the same perioperative enteral nutrition support.Liver function,prealbumin (PA),and C-reactive protein (CRP) levels were measured before and on days 1,3,and 5 after the operation.Human blood albumin infusion volume,postoperative gas passing,postoperative hospital stay,and incidence of complications were recorded.Results The serum level of PA on day 3 after hepatectomy was significantly higher in the steroid group than in the control group [(101.26 ±61.17) mg/L vs.(81.84 ±43.58) mg/L,t =-1.607,P =0.049].The serum level of cholinesterase on day 1 after hepatectomy was significantly higher in the steroid group than in the control group [(5.60±1.54) kU/Lvs.(4.68±1.01) kU/L,t=-3.136,P=0.004].On day1 and day 3 after hepatectomy,the serum levels of CRP were significantly lower in the steroid group than in the control group [(41.79 ±20.86) mg/L vs.(62.08 ±38.33) mg/L,t =2.933,P=0.027;(64.14 ±32.38) mg/L vs.(102.64 ± 49.05) mg/L,t =4.127,P =0.006].The postoperative hospital stay was significantly shorter in the steroid group than in the control group [(12.62 ±5.74) d vs.(15.41 ± 10.00)d,t =1.514,P =0.002].Conclusion Intraoperative use of methylprednisolone combined with perioperative enteral nutrition support may inhibit postoperative inflammatory response,promote early recovery of liver synthetic function,and help to promote rehabilitation after hepatectomy.

Objective To investigate the family burden of patients with severe mental illness. Methods 148 patients with schizophrenia and bipolar disorder were assessed with Family Burden Scale of disease (FBS). Results Family burden broadly exists among those patients with schizophrenia and bipolar disorder, and the burden tends to involve several dimensions, including family relations (51%), home entertainment (50%), daily routine (45%), economic burden (43%), mental health of family members (36%) and physical health of family members (32%). Conclusion Integrated psychological and social intervention should be made to reduce the family burden of patients with schizophrenia and bipolar disorder.